Abstract
The main objective of the present study was to estimate the annual treatment costs of invasive cervical cancer (ICC) per patient at an oncology center in Brazil from a societal perspective by considering direct medical, direct nonmedical, and indirect costs. A cost analysis descriptive study, in which direct medical, direct nonmedical, and indirect costs were collected using a microcosting approach, was conducted between May 2014 and July 2016 from a societal perspective. The study population consisted of women diagnosed with ICC admitted to a tertiary hospital in Recife, state of Pernambuco, Brazil. The annual cost per patient was estimated in terms of the value of American Dollars (US$) in 2016. From a societal perspective, the annual ICC treatment cost per patient was US$ 2,219.73. Direct medical costs were responsible for 81.2% of the total value, of which radiotherapy and outpatient chemotherapy had the largest share. Under the base-case assumption, the estimated cost to the national budget of a year of ICC treatment in the Brazilian population was US$ 25,954,195.04. We found a high economic impact of health care systems treating ICC in a poor region of Brazil. These estimates could be applicable to further evaluations of the cost-effectiveness of preventing and treating ICC.
Highlights
Cervical cancer is the 4th most common malignancy in the world.[1]
Out of the total sample, 38.1% of the patients were without a partner at the time of diagnosis, 56.0% were not involved in cervical cancer screening programs, and 40.3% lived < 60 km away from the IMIP Hospital
The median follow-up was of 19.4 months, and, at the time of follow-up, 83 (62%) patients had recurred, and 45 (33.6%) had died as a consequence of invasive cervical cancer (ICC)
Summary
Cervical cancer is the 4th most common malignancy in the world.[1] in less developed countries, cervical neoplasia is still the 2nd most common type of cancer in women.[2]. In Brazil, invasive cervical cancer (ICC) is the 3rd most common cancer in the female population, and, in 2018, there were an estimated 16,370 new cases (15.43 per 100,000 women). Cervical cancer screening and the treatment of precancerous lesions have successfully reduced the incidence and mortality rates of ICC in many high-income countries, but in low- and middle-income countries, infrastructure weaknesses and financing difficulties for this strategy have limited the control of cervical cancer.[4] In addition, vaccination against the human papillomavirus (HPV), the etiologic agent for ICC, has been available at the Brazilian Public Health System (SUS, in the Portuguese acronym) since 2014.5,6 the benefits of HPV vaccination might not occur for many years
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